Open AccessThoracic outlet syndrome: a rare case with bilateral cervical ribs and bilateral anterior scalene hypertrophy
Author(s) -
Renato Farina,
Pietro Valerio Foti,
Francesco Aldo Iannace,
Alessio Conti,
Agata Ferlito,
Alessandro Conti,
Monica Pennisi,
Serafino Santonocito,
Antonio Basile
Publication year - 2019
Publication title -
journal of ultrasound
Language(s) - English
Resource type - Journals
eISSN - 1971-3495
pISSN - 1876-7931
DOI - 10.1007/s40477-019-00418-w
Subject(s) - medicine , cervical rib , thoracic outlet syndrome , rib cage , subclavian artery , brachial plexus , thoracic outlet , radiology , muscle hypertrophy , anatomy , subclavian vein , surgery , neurovascular bundle , cardiology , catheter
Thoracic outlet syndrome (TOS) is a rare neurovascular disorder generally caused by the presence of a cervical rib or hypertrophic scalene anterior muscle that can compress the brachial plexus and/or subclavian vessels. In the vascular form, the symptoms are caused by the compression of the artery and/or the subclavian vein. In the first case, the compression is caused by the cervical rib and leads to hypo-perfusion with cooling and cyanosis of the upper limb, while in the second case, the compression is caused by the anterior scalene muscle and leads to congestion, cyanosis, swelling and pain in the higher limb. In this paper, we describe a case with the simultaneous presence of a bilateral cervical rib and bilateral hypertrophy of the anterior scalene muscle. TOS diagnosis is based on neurological, clinical and instrumental tests, such as chest radiography and color Doppler ultrasonography. The treatment of these patients can be surgical or conservative.